| NPI | 1194717280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1351) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601003149) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2018-06-13 |